{"page":"https://casescribe.ai/explorer/secondary/sleep-apnea-secondary-to-tinnitus","generated_at":"2026-10-03T18:34:27.357Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Sleep apnea secondary to tinnitus","secondary_condition":"Sleep apnea","service_connected_disability":"tinnitus","decisions":856,"years":"2017-2026","granted_pct":24.1,"denied_pct":15.3,"remanded_pct":60.2,"granted_on_merits_pct":61.1,"by_year":[{"year":2018,"issues":26,"granted_pct":30.8,"denied_pct":23.1,"remanded_pct":46.2},{"year":2019,"issues":29,"granted_pct":17.2,"denied_pct":13.8,"remanded_pct":69},{"year":2020,"issues":38,"granted_pct":13.2,"denied_pct":26.3,"remanded_pct":60.5},{"year":2021,"issues":52,"granted_pct":13.5,"denied_pct":17.3,"remanded_pct":69.2},{"year":2022,"issues":67,"granted_pct":16.4,"denied_pct":11.9,"remanded_pct":70.1},{"year":2023,"issues":87,"granted_pct":17.2,"denied_pct":13.8,"remanded_pct":69},{"year":2024,"issues":141,"granted_pct":22.7,"denied_pct":12.1,"remanded_pct":64.5},{"year":2025,"issues":305,"granted_pct":30.5,"denied_pct":13.8,"remanded_pct":55.1},{"year":2026,"issues":103,"granted_pct":29.1,"denied_pct":18.4,"remanded_pct":52.4}],"benefit_of_doubt_in_grants_pct":75.7,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":57,"granted_pct_with":84.8,"granted_pct_without":58.6},{"evidence":"va_exam_unfavorable","decisions_with":694,"granted_pct_with":58.9,"granted_pct_without":74},{"evidence":"nexus_positive","decisions_with":253,"granted_pct_with":95.7,"granted_pct_without":19.1},{"evidence":"nexus_negative","decisions_with":621,"granted_pct_with":57.4,"granted_pct_without":73.4},{"evidence":"private_opinion","decisions_with":409,"granted_pct_with":79.6,"granted_pct_without":24.1},{"evidence":"lay_statement","decisions_with":592,"granted_pct_with":50.8,"granted_pct_without":86.6},{"evidence":"buddy_statement","decisions_with":44,"granted_pct_with":77.8,"granted_pct_without":60.2}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":30},{"reason":"current diagnosis established","decisions":30},{"reason":"service connection established","decisions":29},{"reason":"aggravated by the service-connected disability","decisions":19},{"reason":"service records negative or silent","decisions":4},{"reason":"va examiner: less likely than not related to service","decisions":4}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":33},{"reason":"service records negative or silent","decisions":27},{"reason":"no in-service complaints, treatment or diagnosis","decisions":23},{"reason":"aggravated by the service-connected disability","decisions":6},{"reason":"preponderance of the evidence against the claim","decisions":6},{"reason":"no current diagnosis","decisions":4}]},"recent_examples":{"granted":[{"case_id":"A26037804","year":2026,"judge":"GAYLE STROMMEN","rationale":"Current diagnosis of sleep apnea established; Service-connected for tinnitus; Private opinion found sleep apnea secondary to tinnitus; Private opinion linked tinnitus to REM disruption and pharyngeal muscle paralysis; Private opinion found highly probative due to thoroughness and rationale"},{"case_id":"A26036777","year":2026,"judge":"COLLEEN M. GLASER-ALLEN","rationale":"Current diagnosis of OSA established.; Service connection for PTSD and tinnitus established.; Private medical opinion found PTSD and tinnitus aggravated OSA via fragmented sleep."},{"case_id":"A26037077","year":2026,"judge":"LEETRA J. HARRIS","rationale":"Favorable finding of current disability (OSA); Favorable finding of service-connected tinnitus; Nexus established by private medical opinion linking OSA to tinnitus"}],"denied":[{"case_id":"A26039381","year":2026,"judge":"ERIC S. LEBOFF","rationale":"Weight of evidence against service connection for OSA; Weight of evidence against OSA being proximately due to or aggravated by tinnitus; Contemporaneous service records did not mention OSA; VA examiner opinions found less likely than not nexus"},{"case_id":"A26038978","year":2026,"judge":"MICHELLE L. KANE","rationale":"Private opinions afforded little weight due to conflation of causation/aggravation standards and suggestion of age/obesity as causes.; VA treatment records noted morbid obesity as a cause for sleep apnea.; VA examiner opined tinnitus does not negatively impact or cause sleep apnea."},{"case_id":"A26038637","year":2026,"judge":"K. CONNER","rationale":"Service treatment records silent for sleep disorder complaints, diagnosis, or treatment.; Diagnosis of moderate OSA occurred over 35 years after service.; Private opinion lacked probative value due to speculative reasoning and incomplete literature interpretation."}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":856,"aggravation_discussed":{"issues":452,"granted_pct":20.8},"causation_only":{"issues":404,"granted_pct":27.7},"issues_naming_a_pathway_pct":30,"pathways":[{"pathway":"Weight gain or obesity","issues":135,"granted_pct":18.5,"examples":[{"case_id":"A26001932","year":2026,"outcome":"GRANTED","quote":"Private medical opinion found thoracolumbar arthritis caused obesity, which caused OSA."},{"case_id":"26001045","year":2026,"outcome":"DENIED","quote":"Other risk factors (age, obesity, anatomy) are more likely etiologies."}]},{"pathway":"Sleep disruption","issues":116,"granted_pct":25,"examples":[{"case_id":"26001001","year":2026,"outcome":"GRANTED","quote":"The Board found the evidence in equipoise, granting service connection based on credible, internally consistent lay statements of sleep disturbance during service, despite no in-service treatment and negative VA nexus opinions."},{"case_id":"A26004390","year":2026,"outcome":"DENIED","quote":"VA examiner diagnosed unspecified insomnia disorder"}]},{"pathway":"Nerve involvement","issues":13,"granted_pct":46.2,"examples":[{"case_id":"A26019184","year":2026,"outcome":"GRANTED","quote":"Private medical opinion found OSA causally related to service-connected tinnitus and radiculopathy with obesity as intermediate step."},{"case_id":"1726897","year":2017,"outcome":"DENIED","quote":"No medical nexus found between sleep apnea and PTSD, peripheral neuropathy, diabetes mellitus, hearing loss, or tinnitus."}]}]},"how_va_rates":{"citation":"38 CFR 4.97","diagnostic_code":"6847","name":"Sleep Apnea Syndromes (Obstructive, Central, Mixed)","url":"https://www.ecfr.gov/current/title-38/section-4.97","levels":[{"criteria":"Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy","rating":100},{"criteria":"Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine","rating":50},{"criteria":"Persistent day-time hypersomnolence","rating":30},{"criteria":"Asymptomatic but with documented sleep disorder breathing","rating":0}],"notes":[]},"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}